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What Does My MRI Scan Report Indicate?

Posted on Mon, 9 Mar 2015

Question: Hi, I was admitted to ER room 2 weeks ago after suffering a seizure (10 minutes long, started in leg and then progressed until body became stiff and i fell onto bed foaming at mouth with eyes rolled back. I came round and felt groggy, having bit my tongue. ER room elevated pulse, hyperglyceimic 170, sweating profusely. CT was clear, blood work clear save elevated cholestorol. Next day mri showed small acute celebral infarction but no physical effects from seizure other than sore tongue.
Admitted for 7 days mannitol/rehydration and drugs to control blod and clotting as well as reduce cholestorol.
Upon discharge diagnosis was viral meningoencephalitis, acute celebral infarction. Ongoing medication for anticoagulation, antiviral agents, anti epeleptic agents.

Answered by Dr. Sudhir Kumar (9 minutes later)

Brief Answer:
Agree with the line of management.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms, MRI and other lab reports and current treatment.

I agree with the line of management. I am glad to note that you have recovered well.

You would need to continue aspirin and statins for long duration to prevent recurrence of stroke in future.

In addition, anti-epileptic medications should also be continued.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (3 minutes later)

what was the role of viral meningoencephalitis in your opinion, the doctore did not mention i had a stroke as i was perfectly ok physically...

Answered by Dr. Sudhir Kumar (3 minutes later)

Brief Answer:
Viral meningoencephalitis is presumptive diagnosis

Detailed Answer:
Thank you for getting back.

In your case, viral meningoencephalitis is a presumptive diagnosis, in view of your presentation with seizures and altered sensorium. In any case, two weeks of antiviral medications would suffice to cure it.

Acute cerebral infarction means brain stroke and it was diagnosed on the basis of MRI brain findings.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (5 minutes later)

finally, viral meningoencephalitis was a likely cause of the infarction. Upon follow up my neurologist said that the light on the mri was more akin to an edema caused by a virus. the infarction itself was very small in the first case, this is the reason i have zero physical effect, like a TIA? I though stroke victims had some paralyssis etc...

Answered by Dr. Sudhir Kumar (2 minutes later)

Brief Answer:
Small strokes may not cause paralysis.

Detailed Answer:
Thank you for getting back.

I agree with your doctor that meningoencephalitis may be the cause of stroke in your case. However, high cholesterol is also a risk factor for stroke.

Regarding paralysis, small strokes such as TIA or lacunar stroke may not cause paralysis in some cases. However, I agree that most strokes cause paralysis.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 hour later)

The neurologist suggested a follow up mri in 1 week, do you think this would be a good course of action.

I will keep going with medication and exercise/diet regime, I guess this is the best course of action.

Any idea why my glucose was so high on admission?

Answered by Dr. Sudhir Kumar (33 minutes later)

Brief Answer:
Agree with current approach and treatment.

Detailed Answer:
Thank you for getting back.

Yes, I agree with current medications and treatment approach.

Also, it is a good idea to perform the MRI after one week.

Blood sugar may go high in times of stress, such as after stroke or encephalitis.

If repeat blood sugar is normal, then, there is no need to worry.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar